Siddharth Ashvin Shah, M.D., M.P.H.

Founder and Medical Director

drshah@greenleaf-is.com

www.greenleaf-is.com

Mental Armoring:

Mitigating the Effects of Vicarious Trauma

for Law Enforcement Officers,

First Responders,

and Mental Health Personnel

Who Respond to the Trauma of Others

May 21, 2013

Oak Creek, Wisconsin

Distinctions

Eustress vs. Distress

Acute vs. Chronic

Burnout vs. Traumatization

Vicarious Trauma

Compassion Fatigue

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Neurobiology of Stress and Trauma

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Brainstem

Subcortical “Under the Hood”

F/F/F Where Trauma

lives

Cortex Conscious Awareness

& Responses

Cortex

Cortex

Cortex

Cortex

Neurobiology of Stress and Trauma

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Amygdala - fear/aversion

Brainstem Stressor (perceived by 5 senses)

Conscious response to threat

Neurotransmitters

Lessons Learned from Neurobiology

1. Stress is not intangible; there are electrochemical

pathways that drive reactions.

2. In order to “survive,” brain prioritizes subcortical habits.

3. Resiliency skills Enhanced subcortical habits

– Self-regulation

– Protection against injury

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Resiliency 2.0

Our Updated Approach to Resiliency

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Scientific basis Psychotherapy

Neurological

locus

Mainly cortical

Training

modalities

Inspiring tips &

exhortations

Neurobiology

and psychology

Cortical &

sub-cortical

Concrete

behavior

change

coaching

Resiliency 1.0

• Takes advantage of findings

in the last 5-10 years.

Leverages new technologies

like fMRI.

Advantages of Resiliency 2.0

• Many stress reactions can

only be illuminated &

modified by understanding

sub-cortical processes.

• More targeted, comprehensive

and integrated. Resiliency 2.0

training engages individuals not

benefitted by tips/exhortations.

What Resiliency Is – and Isn’t

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Resiliency involves learning

behaviors, thoughts, and actions.

Resiliency is an

inherent trait.

Resilient people still feel sad, angry,

or frustrated when faced with a

setback. But they find ways to

move forward and tackle challenges

with creativity, hope, and a positive

attitude.

Resilience is about

“toughing it out” or

reacting to every

setback with a smile.

Resiliency and smart responses go

together. It can be the difference

between success and failure. Or

the difference between recovery

and despair.

Resiliency means

chilling out and

not taking things

seriously.

REALITY MYTHS

Resilient Workforces Avoid:

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• Compromised performance

• Turnover

• Low morale, disillusionment

• Traumatic reactions

• Maladaptive behaviors (e.g.

passive-aggressive workplace

behavior, bullying, excessive

alcohol use, absenteeism)

Exercise:

Getting down to what matters to you

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STRESS INVENTORY

• Note your long-term patterns and trends (left column)

• Note any short-term stress symptoms (right column)

Discussion

• Gather into groups of three

• Each individual will share for 2 minutes the barriers to self-

care in the midst of doing work that involves seeing the

underbelly of life

• The small group will then decide what to share with the

larger group

Practical Skill:

Breathing A. Abdominal Breathing

– To ensure that breath goes to lower lung fields,

lengthen exhale

B. Alternate Nostril Breathing

– inhale right nostril, exhale left, inhale left, exhale right

C. Harmonized Breathing Words

– (silence)...One

– Calming…Down

– Soft…Belly

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Practical Skill:

Get the Good Stuff

• Write down three good things that happened today

1. ___________________________________________

2. ___________________________________________

3. ___________________________________________

• Then plan out how you can get more good stuff tomorrow

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My Resiliency Plan

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For me

For my

colleagues

• Practice breathing

• Use audio/video aids

• _________________________

• _________________________

• _________________________

• _________________________

• _________________________

First thing Friday_______

____________________

____________________

____________________

____________________

____________________

____________________

• Share this class with colleagues

• Assess needs & capacities

• Encourage training for my team

• _________________________

• _________________________

• _________________________

• _________________________

____________________

____________________

____________________

____________________

____________________

____________________

____________________

What I will do: When I will do it:

____________________

____________________

____________________

____________________

____________________

____________________

____________________

____________________

____________________

____________________

____________________

____________________

____________________

____________________

Resources needed:

Key Takeaways

• Resiliency is not an “inherent” trait.

It is a practical skill.

• Resiliency improves with training.

• Organizations ignore resiliency at

their peril.

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OPTIONAL slides to follow – if time permits

How Visualization Works

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2 Everly and Strouse. The Secrets of Resilient Leadership: When Failure is Not an Option (2010).

Stress Management as a Competitive Advantage 2

“Using advanced statistical techniques… we discovered that how a

person views the world exerts a powerful, if not more powerful

effect, than the actual events themselves.”

Basis for Mind over Matter 1

Dr. Candace B. Pert is among the pioneers who illuminated the

biological mechanisms by which mind-body modalities achieve

what they do. Therapeutic visualization (or guided imagery) has

been documented to improve immune system functioning and

reduce hospital stays.

1 Pert. Molecules of Emotion (1999).

Practical Skill:

Visualization of Resiliency

• Purposeful Daydreaming

• Promoted in athletes and

soldiers to “see” success

1. Centering Breath

2. Performance Statement

3. Highlights Reel

4. Future Situation

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